| NPI | 1023268570 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLORIA ANN MILLER Administrator 904-398-0734 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness (Licence: FL AL11371) |
| Enumeration Date | 2008-09-21 |
| Last Update Date | 2009-01-07 |